8U81NES8. CONSUMER SERVICES ANDHDUBINGAGENCY ~SD~E~2~G.tt~~. #7.A.3.



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cc:a BTATS CP CA.LIPDRNIA 2535 DEPARTMENT OF CONSUMER AFFAIRS 8U81NES8. CONSUMER SERVICES ANDHDUBINGAGENCY ~SD~E~2~G.tt~~. #7.A.3. Board of Vocational Nursing and Psychiatric Technicians Capitol Oaks Drive Suite 205, Sacramento, CA 95833-2945 Phone 916-263-7800 Fax 916-263-7855 Web www.bvnpt.ca.gov DATE: April 28, 2015 TO: FROM: Board Members ~ Jessica Gomez, M.S.N., R.N. Nursing Education Consultant SUBJECT: Sierra Pacific College Vocational Nursing Program - Reconsideration of Provisional Approval; Consideration of Request to Admit Students (Director: Bernadette Bautista, Redlands, San Bernardino County, Private) On May 11, 2012, the Board placed Sierra Pacific College Vocational Nursing Program on provisional approval for the two-year period from May 11, 2012 through May 31, 2014. That action was taken due to the program's noncompliance with Section 2530 (I) of the Vocational Nursing Rules and Regulations, which states: "The program shall maintain a yearly average minimum pass rate on the licensure examination that does not fall below 10 percentage points of the state average pass rate for first time candidates of approved vocational nursing schools for the same period." On May 16, 2014, the Board extended the program's provisional approval through May 30, 2015. Further, the Board declined to consider any request to admit students until the program obtains and submits documentation substantiating approval to operate by the Department of Consumer Affairs' Bureau for Private Postsecondary Education. The program was placed on the Board's May 2015 agenda for reconsideration of its provisional status. The program is presented to the Board for reconsideration of provisional approval. Additionally, the director requests approval to admit a class of 15 students commencing June 15, 2015, and graduating on July 1, 2016. History of Prior Board Actions (See Attachment A, History of Board Actions) Enrollment The program is approved by the Board to offer a 52-week full-time course of instruction. Board approval is required prior to the admission of each class.

The following table represents past and proposed student enrollment from February 2009 through June 2015. The table indicates a maximum enrollment of 15 students for the period February 2009 through June 2015. Currently, there are no students enrolled in the program. ' i.rnrqbt..menr o~ra... L :.:i.:............ :... start.. Con1plet(3 2/09 24 21 21 2/10 2/09 Class) -21 21-21 = 0 6/10 10 10 0+10=10 7/11 (6/1 0 Class) -10 10-10=0 2/11 8 8 0+8=8 2/12 (2/11 Class) -8 8-8=0 6/12 (Approved 5/12; 15 0 0+0=0 Not Started) 6 /15 (Proposed) 7/16 15 0+15=15 Licensing Examination Statistics The following statistics, furnished by Pearson Vue, and published by the National Council of State Boards of Nursing as "Jurisdictional Summary of All First-Time Candidates Educated in Member Board Jurisdiction," specify pass percentage rates for graduates of the Sierra Pacific College Vocational Nursing Program on the National Council Licensure Examination for PracticaiNocational Nurses (NCLEX-PN ) for the period for the period of July 2010 through March 2015. Oct- Dec 2010 5 2 40% 77% 50% 76% -26 Jan- Mar 2011 8 12% 80% 27% 75% -48 Apr- Jun 2011 4 0 0% 71% 22% 76% -54 2

Oct- Dec 2011 No Candidates Tested 74% 8% 75% Jan- Mar 2012 3 2 67% 74% 29% 76% Apr- Jun 2012 0 0% 72% 50% 75% Jul- Sep 2012 8 38% 74% 42% 74% -32 3 Oct- Dec 2012 100% 70% 46% 74% -28 Jan- Mar 2013 No Candidates Tested 73% 40% 73% -33 Apr- Jun 2013 No Candidates Tested 78% 44% 73% -29 Jui-Sep2013 0 0% 75% 50% 74% -24 Oct- Dec 2013 No Candidates Tested 76% 0% 76% -76 Jan- Mar 2014 No Candidates Tested 74% 0% 76% -76 Apr- Jun 2014 No Candidates Tested 66% 0% 73% -73 Jul- Sep 2014 No Candidates Tested 72% N/A 73% N/A Oct- Dec 2014 No Candidates Tested 72% N/A 72% N/A Jan- Mar 2015 No Candidates Tested 73% N/A 71% N/A *The Annual Pass Rate changes every quarter. It is calculated by dividing the number of candidates who passed during the current and previous three-quarters by the number of candidates who tested during the same period. If no data is available for the relevant period, the statistic is carried over from the last quarter for which data is available. California Code of Regulations section 2530(1) states: "The program shall maintain a yearly average mm1mum pass rate on the licensure examination that does not fall below 10 percentage points of the state average pass rate for first time candidate of approved vocational nursing schools for the same period." Based on published examination statistics for the period January 2010 through March 2015, the program's average annual pass rate is 0%. The California average annual pass rate for graduates from approved vocational nursing programs who took the NCLEX-PN for the first time during the same period is 71%. The pass rate for Sierra Pacific College is 71 percentage points below the State average annual pass rate. It is noted that the program's last class of eight (8) students graduated February 2012. The program has had no graduates tested since September 2013. Faculty and Facilities: Section 2534(d) of the California Code of Regulations (Code) states: 3-67 -47-25

"For supervision of clinical experience, there shall be a maximum of 15 students for each instructor." The current number of Board-approved faculty totals four (4), including the program director. The director has 50% administrative and 50% teaching duties. Of the total faculty, five (5) instructors are approved to teach clinical. Based upon a maximum of 15 students, one (1) instructor is required for clinical supervision. Therefore, the current number of faculty is adequate for the proposed enrollment. Section 2534(b) of the Code states: "Schools shall have clinical facilities adequate as to number, type, and variety of patients treated, to provide clinical experiences for all students in the area specified by Section 2533. There must be available for student assignment, an adequate daily census of patients to afford a variety of clinical experiences consistent with competency-based objectives and theory being taught." The program has clinical facilities that are adequate as to type and variety of patients treated to enable current and proposed students to meet clinical objectives in accordance with Section 2534(b) of the Code. Other Considerations On May 2012, the Board placed the Sierra Pacific College Vocational Nursing Program on provisional approval for the two- year period from May 11, 2012 through May 31, 2014, due to noncompliance with regulatory requirements relative to program pass rates on the licensure examination, due to an annual average pass rate of 29%. Additionally, the Board approved the program's admission of a class of 15 students on June 11, 2012. Based on information submitted by the director, the program did not admit that class. On April 16, 2014, the Board received information regarding actions taken by the Department of Consumer Affairs' Bureau for Private Postsecondary Education (Bureau) relative to the program. As reported, the Bureau received a complaint on March 12, 2012, alleging the program's refusal to provide an official transcript to a former student. Reportedly, the complainant had completed the program in March 2012. On April11 2012, the Bureau issued a notice directing the program to cease operation due to its lack of Bureau approval. On May 13, 2014, the Board extended the program's provisional approval through May 30, 2015. The Board noted that the program had a total of 11 graduates tested from April 1, 2012 through March 2014; of the total tested four (4) passed and seven (7) failed. The Board declined to consider any request to admit students until the program obtains and submits documentation substantiating approval to operate by the Bureau. 4

On February 9, 2015, the Board received a copy of the Bureau's approval of Sierra Pacific College to operate a non- degree granting vocational nursing program. The approval is dated January 22, 2015. (See Attachment B). As noted previously, the program's current average annual pass rate on the NCLEX-PN is 0%. Published examination statistics confirm that the program has had no graduates completing the licensure examination since September 2013. On March 5, 2015, the Board requested documentation from the director relative to the availability of critical resources, including, but not limited to faculty, clinical facilities, library, staff and support services, physical space, skills laboratory and equipment required to achieve the program's objectives. To date, three (3) faculty members have provided letters confirming their availability to teach in the Sierra Pacific College Vocational Nursing Program. On April 13, 2015, the Board approved two (2) long term facilities for clinical placement of students. On April 17, 2015 the Board approved one (1) maternity nursing facility, four (4) pediatric nursing facilities, and three (3) adult geriatric and medical surgical facilities. The newly approved facilities provide adequate clinical sites to provide clinical experiences that are consistent with the curriculum and of like character and quality for the proposed enrollment. Given the foregoing, the following violation remains. Section 2530 (I) of the California Code of Regulations states: "The program shall maintain a yearly average minimum pass rate on the licensure examination that does not fall below 10 percentage points of the state average pass rate for first time candidates of accredited vocational nursing schools for the same period." Violation #1: Status: Based on published examination statistics, the program has failed to maintain an average annual pass rate that is compliant with regulatory requirements. Specifically, the program's average annual pass rates have been more than ten (1 0) percentage points below State average annual pass rates for eighteen (18) consecutive quarters. For the last three (3) most current quarters (July 2014 through December 2014), the program had no graduates tested. This violation is not corrected. The violation will be corrected when the program's pass rates improve and are consistent with regulatory requirements. Recommendations: 1. Extend provisional approval of the Sierra Pacific College Vocational Nursing Program for the two (2) year period from May 30, 2015, through May 29, 2017, and issue a notice to the program to identify specific area of noncompliance and requirements for correction as referenced in Section 2526.1 (e) of the California Code of Regulations. 5

2. Require the program to bring its average annual pass rate to no more than ten (10) percentage points below the State average annual pass rate. 3. Approve the program's request to admit a class of 15 students commencing June 15, 2015 and graduating on July 1, 2016, only. 4. Require the program to maintain to maintain and instructor to student ratio that does not exceed ten (1 0) students for each instructor in during clinical experience. 5. Require the program director to submit, under penalty of perjury, the names of all enrolled students, date of admission, placement in the curriculum, and expected date of graduation by July 1, 2015. 6. Continue the program's requirement to obtain approval by the full Board prior to the admission of future classes. 7. Require the program to submit follow-up reports in nine months, but no later than February 1, 2016, and 22 months, but no later than February 1, 2017. The reports must include a comprehensive analysis of the program, specific actions taken to improve program pass rates, timeline for implementation, and the effect of employed interventions. The following elements must be addressed in the analysis: a. Admission Criteria b. Screening and Selection Criteria c. Terminal Objectives. d. Curriculum Objectives. e. Instructional Plan. f. Theory and Clinical Objectives for Each Course. g. Lesson Plans for Each Course h. Textbooks i. Attendance Policy j. Remediation Policy. k. Evaluation of Theory and Clinical Faculty. I. Evaluation of Theory Presentations. m. Evaluation of Clinical Rotations and Their Correlation to Theory Presentations. n. Evaluation of Student Ac~iever;nent. o. Current Enrollment; and, 8. Require the program to comply with all approval standards in Article 4 of the Vocational Nursing Practice Act, commencing at Business and Professional Code Section 2880, and Article 5 of the Board's Regulations, commencing at California Code of Regulations, Title 16, Section 2526. 9. Require the program to demonstrate incremental progress in correcting the violation. If the program fails to satisfactorily demonstrate incremental progress, the full Board may revoke the program's approval. 6

10. Failure of the program to take any of these corrective actions may cause the full Board to revoke the program's approval. 11. Place the program on the Board's May 2016 agenda for reconsideration of provisional approval. Rationale: The program was placed on provisional approval on May 11, 2012, the program's average annual pass rate was 29%, 45 percentage points below the state average annual pass rate. Subsequent to the program being placed on provisional approval, the program's average annual pass rate rose to a high of 50% during Quarter 2-2012 and Quarter 3-2013. Since Quarter 3-2013, the program has had no graduates completing the licensure examination. As stated previously, on May 16, 2014 the Board extended the program's provisional approval for one year through May 30, 2015. Additionally, the Board declined to consider any request to admit students until the program obtains and submits documentation substantiating approval to operate by the Department of Consumer Affairs' Bureau for Private Postsecondary Education (Bureau). On February 4, 2015, the Board received a copy of the Bureau's approval for Sierra Pacific College to operate a non- degree granting vocational nursing program. That approval was dated January 22, 2015. The adequacy of program resources to provide instruction for the proposed students has been verified. Those resources include Board- approved faculty, and clinical facilities adequate as to number, type, and variety of patients treated, to provide clinical experiences consistent with the curriculum and of like character and quality for the proposed enrollment. Given the foregoing, it is prudent to extend the program's provisional approval for two (2) years. Currently, no students are enrolled in the program. Approving the requested class will allow the implementation of the curriculum and corrective actions required to improve student comprehension and the program's pass rates on the licensure examination. Board staff will continue to monitor the program's effectiveness by tracking class admissions, resources, and the program's quarterly pass rates. Attachment A: History of Prior Board Actions Attachment B: Program Correspondence Dated February 4, 2015; Received February 9, 2015 Attachment C: BPPE Approval, Date of Approval January 22, 2015 7

History of Prior Board Actions Agenda Item# 7.A.3., Attachment A SIERRA PACIFIC COLLEGE VOCATIONAL NURSING PROGRAM On January 14, 2009, the Executive Officer approved Sierra Pacific College, Redlands, to begin a vocational nursing program with an initial class of 24 students on January 19, 2009 only, with a projected graduation date of February 5, 201 0; and, approved the program curriculum for 1578 hours, including 596 theory and 982 clinical hours. On April 21, 2010 an initial site visit was completed by the Nursing Education Consultant. On June 3, 2010, the Executive Officer approved initial full accreditation for Sierra Pacific College, Redlands, Vocational Nursing Program for the four (4) year period from June 3, 2010 through June 2, 2014, and; directed staff to issue a certificate accordingly, and; approved the programs request admit 30 students on June 7, 2010 graduating on of July 10, 2011; and, required the program to submit revised admission criteria and procedures to include entrance testing for incoming students by June 25, 201 0; and, required the program to obtain Board approval prior to the admission of each class. On January 25, 2011, the Executive Officer approved the program to admit a fulltime class of 30 students commencing on January 31, 2011 and graduating on January 27, 2012; and, denied the program's request to admit a class of 30 students commencing on July 11, 2011 and graduating July 27, 2012 to replace students graduating on June 17, 2011; and, board staff will continue to monitor the program by tracking its licensure examination pass rate quarterly. On March 15, 2012, the program was notified that its average annual pass rates had fallen more than ten (10) percentage points below the state average annual pass rates for the past five (5) consecutive quarters and the Board was scheduled to consider placement of the program on provisional approval at the May 2012 Board meeting. The following information was requested by March 23, 2012. On March 23, 2012, the program was notified that its average annual pass rate had fallen more than ten (10) percentage points below the state average annual pass rates for the past six (6) quarters, per verbal communication. 1

On March 28, 2012, the Board received the program's plan to increase the licensure pass rates and related forms. On April 4, 2012, the assigned consultant forwarded correspondence requesting submission of eighteen (18) copies of pertinent documents for Board consideration to include, but not be limited to, its plan to correct its noncompliant pass rates, and the effect of subsequent corrective action taken to correct identified deficiencies. On May 11, 2012, the Board placed Sierra Pacific College, Vocational Nursing Program, on provisional approval for the two-year period from May 11, 2012, through May 31, 2014; and, issued a notice to the program to identify specific area of non-compliance and requirements for correction as references in Section 2526.1 of the California Code of Regulations; and required the program to bring its average annual pass rate to no more than ten (1 0) percentage poir:1ts below the State average annual pass rate; and, Required the program to submit follow-up reports in nine months, but no later than February 1, 2013, and 21 months, but no later than February 1, 2014. The reports must include a comprehensive analysis of the program, specific actions taken to improve program pass rates, timeline for implementation, and the effect of employed interventions. The following elements must be addressed in the analysis: a. Admission Criteria b. Screening and Selection Criteria c. Terminal Objectives. d. Curriculum Objectives. e. Instructional Plan. f. Theory and Clinical Objectives for Each Course. g. Lesson Plans for Each Course h. Textbooks i. Attendance Policy j. Remediation Policy. k. Evaluation of Theory and Clinical Faculty. I. Evaluation of Theory Presentations. m. Evaluation of Clinical Rotations and Their Correlation to Theory Presentations. n. Evaluation of Student Achievement. o. Current Enrollment; and, Required the program to comply with all approval standards in Article 4 of the Vocational Nursing Practice Act, commencing at Business and Professional Code Section 2880, and Article 5 of the Board's Regulations, commencing at California Code of Regulations, Title 16, Section 2526; and, required the program to demonstrate incremental progress in correcting the violation. If the program fails to satisfactorily demonstrate incremental progress, the full Board may revoke the program's approval; and, advised the program that failure to take any of these corrective actions may cause the full Board to revoke the program's approval; and, approved Sierra Pacific College, Vocational Nursing Program's 2

request to admit 15 students commencing on June 11, 2012 and graduating on June 28, 2013 to replace students who graduated on February 8, 2012; and, required the program to admit no additional students without prior approval by the full Board; and, Placed the program on the May 2014 Board agenda for reconsideration of provisional approval. On February 18, 2014, the Nursing Education Consultant notified Sierra Pacific College, Vocational Nursing Director and requested the follow-up report that was due on February 1, 2014. On March 6, 2014, the required follow-up report was submitted to the Nursing Education Consultant. On May 13, 2014, the Board extended provisional approval for the Sierra Pacific College, Redlands, Vocational Nursing Program for one year from May 16, 2014 to May 30, 2015, and issued a notice to the program to identify specific area of noncompliance and requirements for correction as referenced in Section 2526.1 (e) of the California Code of Regulations; and denied the program's request to admit a class of 15 full-time students on June 16, 2014 only, graduating on June 26, 2015; and declined to consider any request to admit students until the program obtains and submits documentation substantiating approval to operate by the Department of Consumer Affairs' Bureau for Private Postsecondary Education; and required the program to admit no additional students unless approved by the full board, including any previously approved classes that were not admitted; and required the program to submit a follow-up report in six (6) months after admission of the next class. The report must include a comprehensive analysis of the program, specific actions taken to improve program pass rates, timeline for implementation, and the effect of employed interventions. The report must address all elements as identified in the comprehensive analysis submitted September 2013. The following elements must be addressed in the analysis. a. Admission Criteria b. Screening and Selection Criteria c. Terminal Objectives d. Curriculum Objectives e. Curriculum Evaluation f. Instructional Plan g. Theory and Clinical Objectives for Each Course h. Lesson Plans for Each Course i. Textbooks j. Attendance Policy k. Remediation Policy I. Evaluation of Theory and Clinical Faculty m. Evaluations of Theory Presentations n. Evaluations of Clinical Rotations and Their Correlation to Theory Presentation. o. Evaluations of Student Achievement p. Current Enrollment; and 3

Further, the Board required the program to bring its average pass rate to no more than ten (10) percentage points below the state annual pass rate; and required the program to comply with all approval standards in Article 4 of the Vocational Nursing Practice Act, commencing at Business and Professions Code Section 2880, and Article 5 of the Board's Regulations, commencing at California Code of Regulations, Title 16, Section 2526; and required the program to demonstrate incremental progress in correcting the violations. If the program fails to satisfactorily demonstrate incremental progress, the full Board may revoke the program's approval. The Board specified that failure by the program to take any of these corrective actions may cause the full Board to revoke the program's approval; and placed the program on the May 2015 Board agenda for reconsideration of provisional approval. On February 4, 2015 the Board received a copy of the Bureau for Private Postsecondary Education's approval for Sierra Pacific College, dated January 22, 2015. 4

Agenda Item #7.A.3., Attachment 8 \- ~" '., I \c. Wednesday, February 04,2015 Jessica Gomez MSN, RN Nursing Education Consultant Board of Vocational Nursing & Psychiatric Technicians 253 5 Capitol Oaks Drive, Suite 205 Sacramento, CA 95833 916-263-7839 Dear Jessica: After years of waiting, enclosed is the approval from Bureau for Private Postsecondary Education (BPPE). The agency requires a copy of the BPPE approval sent to you. The school requests to start class on April 20, 2015 and program completion on April 29, 2016. The school main concern at this time is regarding the Provisional status which is about to expire on May, 2015. Please inform the school regarding the Provisional status and what to do from here on. Thanks for your kind consideration on this matter. ~LJ- Bernadette N. Bautista, RN, MSN Director of Nursing Sierra Pacific College - ------- 1200 Ari;un:1 SL. Suite A-2 *Redlands. CA 9:2:n4 Phone {909) 792-2.255 Fax (909) 792-2275 --- -- --

Edmund Agenda Item #7.A.3., Attachment C Buslnessr Consumer Services! <~nc! Housing ;\gency M G. Brown Jr., Governor Bureau for Private Postsecondary Education 2535 Capitol Oaks Drive, Suite 400, Sacramento, CA 95833 8PPE P.O. Box 980818, West Sacramento, CA 95798-0818 Approved Educational Program List In accordance with the provisions of California Education Code 94866 or 94890, the Bureau for Private Postsecondary Education approves: Sierra Pacific College 1200 Arizona St. Ste. A-2 Redlands, CA 92374 School Code#: 90919988 Site Type: 11-fain to offer the following program(s)!course(s): Length of Program Distance Program Type Program Name Instruction Approved Learning LVN 79 Units 1,578.00Hours 01/22/2015 Non-Degree No Non-Degree (Vocational) Programs\Courses: 1 Total Programs/Courses: 1 The program list above represents all currently approved educational programs for this institution. The Main, Branch, or Satellite locations ofthis institution may offer any subset ofthis list. Leeza Rifredi, Manager This document is valid if all fees are cuuent. Subject to earlier tennination in accordance with the law. Approved/Registered Program list associuted with Iustitution Approval# 22948, which expires on January 22, 2020. Page 1 ofl Printed: 112612015